It has never been easy dealing with infertility, but thanks to fertility drugs, for example, Lupron and assisted reproductive technology like in vitro fertilization which has brought a ray of hope to many women struggling with conception challenges. For a clear understanding of how the drug works in IVF, it’s advisable to comprehend the female reproductive system which is very complex; a number of hormones, organs, and glands must work as expected and at the right time.
The hypothalamus gland located in your brain produces gonadotropin- releasing hormone (GnRH) on the first day of the monthly period. GnRH sends a signal to the pituitary gland to release follicle stimulating hormone (FSH) and luteinizing hormone (LH). As the pituitary gland is releasing both FSH and LH, it preserves most of the luteinizing hormone for later use. In the first days of the menses, follicle stimulating hormone is released the most. This is the start of what is termed as the follicular phase of the monthly cycle. During this particular phase, almost five to seven follicles in the ovaries start growing. FSH encourages their growth, in other words, the hormone induces the follicles to grow. As they develop, the follicles start to produce estrogen hormone. The estrogen travels in the blood stream and lands back to the pituitary gland, causing the gland to reduce the production of FSH, as estrogen rises, FSH decreases. Eventually, the most dominant follicle produces more estrogen into the bloodstream. Once the follicle is in its final stages of maturity, as estrogen levels rise, FSH increases as well. However, after the final rise of FSH, the pituitary gland suddenly slows down the follicle stimulating hormone production. The next phase is termed as ovulatory phase begins.
The ovarian follicles continue to mature and produce estrogen as the FSH level decreases. The estrogen stimulates the lining of the uterus to grow and increases the fertile cervical mucus. Once the follicle is about to be released, estrogen levels get to the peak causing the pituitary gland to become more sensitive to the GnRH; this triggers the release of the stored luteinizing hormone. The surge in LH sends a signal to the follicle to release an egg. Within a day or two of the luteinizing hormone surge, the most dominant ovarian follicle ruptures, and ovulation take place. If there is a viable sperm, fertilization occurs. If fertilization doesn’t take place, menstruation begins after a couple of days.
The elaborated process isn’t obvious for every woman, that’s why a fertility expert may recommend Lupron for IVF.
Uses in IVF
Wondering what is Lupron used for in IVF? Lupron is a synthetic hormone which resembles a natural hormone produced in the brain. It decreases the amount of estrogen and it’s given through injections. It is a gonadotropin releasing hormone that shuts down the pituitary gland, thus reducing the production of estrogen in women. For a female, this triggers the artificial rapid onset of menopause. As earlier mentioned, in vitro fertilization is an example of assisted reproductive technology. In IVF a female is stimulated with injected drugs for growth and development of multiple follicles; follicles are structures which contain the eggs. Normally, during IVF stimulation protocols, different medications are given administered through shots. A medicine is given to suppress the release of an egg(s) before they are retrieved. The other drug is used to induce multiple egg development and the final medication triggers ovulation.
The most common used IVF protocol is known as down-regulation or long Lupron. Down-regulation is an important part of IVF treatment which enables the fertility specialist to better control egg maturation and ovulation during the treatment. Lupron in IVF down-regulates the ovaries.
During Lupron IVF protocol, the patient starts to receive the injections on the 21st day of the menstrual cycle. The shots are given after an egg has been released by the ovaries because if given prior ovulation, the drug can actually induce ovulation.
At first, after taking an injection, your body responds by producing elevated levels of follicle stimulating hormone and luteinizing hormone. Eventually, the cells in the ovaries and the pituitary gland become overwhelmed and this leads to desensitization. This means FSH and LH production is stopped as well as estrogen production. After getting the drug injection for a couple of days or even weeks (it depends on how long a patient will respond to the drug), a series of tests such as ultrasound and blood test are carried out to confirm the ovaries aren’t producing eggs and the endometrium (lining of the uterus) is thin.
The patient will get her menses on the 28th day of her cycle or on the expected day. The next drug is given a few days after the menses starts. The medication used contain man-made follicle stimulating hormone which stimulates the ovaries for multiple follicles and eggs. Below are injectable follicle stimulating hormone available in the market:
Blood and ultrasound testing are done after every two to three days to check the growth of the follicles in the ovaries and the level of hormones. If the female’s follicles are mature and sufficient, human chorionic gonadotropin (HCG) injection is given to induce ovulation. The eggs are harvested from the ovaries 36 hours after receiving the HCG injection. Fertilization takes place in the laboratory dish and the embryo(s) is (are) transferred back to the uterus. The medicines which contain HCG are:
Has your question on what does Lupron do in IVF been tackled? Well, in a nutshell, this medication prevents the pituitary gland to control the ovary; this minimizes the chance of unintended ovulation during IVF and gives the fertility expert full control of a woman’s reproductive system.
How to Inject
Lupron injection for IVF can be given by the patient or the spouse. The technique is easy to learn and involve the following steps:
- Wash your hands thoroughly with soap and the surface you will work on
- Assemble all the injection materials and place them on the cleaned surface
- Choose the injection spot for Lupron. The injection sites include the abdomen, thigh, and the back of the upper arm or any other area shown by the nurse
- Cleanse the area with alcohol swabs, starting at the center of the chosen spot and moving outward in a circular motion. Allow the area to air-dry to prevent a stinging sensation once you self-administer the shot
- Pull the needle cover carefully to avoid loosening the needle from the syringe
- To remove the air bubbles, hold the needle pointing upwards and tap the syringe gently, you will notice the air bubbles rising and settling at the top. Push the syringe plunger gently till you notice some liquid at the tip of the needle
- Pinch the area you cleaned with the alcohol swab and hold the needle like a pencil at least one inch above the injection site. Insert the needle using a dart like motion and push the plunger gently injecting all the content and release the pinched skin, pull the needle quickly but gently.
- Apply pressure to stop bleeding if any, and cover with a gauze and bandage if need be
- Dispose of the syringe and other materials used in a sharp container or in an unbreakable plastic container.
If you don’t comprehend the injection procedure, don’t self-administer the shots at home; take a refresher course on injection procedure. Remember to rotate the injection sites the next time you have the shot to prevent side effects on the injection site from worsening.
While on Lupron and IVF, expect to be faced with unwanted effects. The medication works by lowering some certain hormones in the body and this triggers undesirable effects, which vary from one patient to another and they can be mild or severe. Below are major side effects of Lupron which require immediate medical intervention:
- Fast or irregular heartbeat
- Bone muscle or joint pain
- Troubled breathing
- Numbness or tingling of the hands or feet
- Tightness in the chest
- Mood changes
- Mental depression
- Increased hair growth
The minor or the mild side effects of Lupron may not need medical attention. As the body adjusts to the medication, the unfavorable effects go away. The health care professional may be able to give some remedies to prevent or reduce some of the drug negative effects. Nonetheless, if the following negative effects continue, becomes bothersome or have queries concerning them, do not hesitate to contact the doctor:
- Hot flashes
- Weight gain
- Trouble sleeping
- Breast swelling or tenderness
- Low libido
- Bleeding, swelling, itching, pain and redness in the injected area
- Irregular vaginal bleeding
- Burning, itching or dryness of the vaginal
Please take note, the listed side effects don’t include all the possible negative effects and you can refer to the physician or pharmacist for additional side effects.
Lupron trigger IVF success rate is high if used with other fertility medications. The controlled ovarian stimulation increases the chances of conception because of multiple follicles. The drug cost is high and requires one to save in advance to be in a position to meet the cost plus any additional expenses such as ultrasounds and blood tests carried out during the treatment. You may compare Lupron price from different fertility clinics and go for the most affordable.
Disclaimer: The contents of this article are for informational purposes only and must not be considered as medical advice. YouDrugstore does not endorse or approve the opinions or views expressed by any contributing author in our community articles. Always consult your doctor for medical advice.